The efficacies of two different surgical approaches, aspiration and excision, were investigated for the management of large solitary encapsulated pyogenic brain abscess located in superficial non-eloquent areas, and the impact on length of hospital stay, duration of postoperative antibiotic use, improvement in neurological status, and morbidity and mortality were compared. This retrospective study at Sher-iKashmir Institute of Medical Sciences included 47 patients with pyogenic brain abscess from a total of 114 patients evaluated in the Department of Neurosurgery over a period of 10 years from October 2001 to October 2011. Comparisons were made between aspiration and excision in terms of duration of antibiotic use, length of hospital stay, and overall treatment cost. Aspiration was performed in 29 patients (61.7%), of whom 7 patients needed second aspiration, and 18 patients underwent excision (38.3%) of the abscess capsule. The mean duration of antibiotic use in the excision group was significantly shorter at 2.7 weeks (standard deviation [SD] ± 1.1) compared to the aspiration group at 3.8 weeks (SD ± 1.3) (p ＝ 0.006). Similarly, mean length of hospital stay was significantly shorter in the excision group at 18.1 days (SD ± 7.7) compared to the aspiration group at 24.9 days (SD ± 6.6) (p ＝ 0.002). In addition, significantly earlier improvement in neurological function (p ＝ 0.025) and significantly lower rate of re-surgery (p ＝ 0.0238) were found in the excision group compared to the aspiration group. Excision is better than aspiration as far as duration of antibiotic use, length of hospital stay, and overall cost of treatment is concerned, with no significant difference in morbidity and mortality.

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Every three minutes, a woman in the United States is diagnosed with breast cancer. Every twelve minutes a woman dies from breast cancer. Breast cancer comprises 22.9% of all cancers (excluding non-melanoma skin cancers) in women, 1 worldwide. In 2008, breast cancer caused 458,503 deaths 1 worldwide (13.7% of cancer deaths in women). Breast cancer is more than 100 times more common in women than breast cancer in men, although males tend to have poorer outcomes 2,3 due to delays in diagnosis. No one dies of cancer in the breast, only of cancer that has spread to other parts of the body. Breast cancer is the commonest cause of cancer death in women worldwide. Rates vary about five-fold around the world, but they are increasing in regions that until recently had low rates of the disease. Lot of progress has been made in the understanding of risk factors (Table 1) and management of breast cancer. The concept of radical surgery has been replaced by the more conservative one without significant compromise in terms of results.Opting for simple mastectomy or wide local excision and adjuvant radiotherapy, rather than obligatory mastectomy, be it radical or modified radical, reflects a significant shift in the 4 understanding of breast cancer pathology and management.Multimodal treatments -both loco-regional, in the form of breast conservation surgery and radiotherapy, and systemic like endocrine treatment and chemotherapy, has resulted in reduced postsurgical morbidity without compromising 5 oncological outcomes. Neo-adjuvant chemotherapy or endocrine therapy is increasingly being applied to improve the chance of successful conservation surgery in the same way as it 6,7 can render operable the inoperable. Before discussing Breast conservative therapy, a brief mention regarding Breast cancer as such, is made below.